Have You Been Scheduled Into Vacation?
This is a contract violation. Don't let this happen to you.
The collective bargaining agreement is extremely clear on what a day is. It's a 24-hour period that begins at 12:00 am. You must not be scheduled to work past midnight on a day that precedes the start of your vacation.
This does not mean that you can be scheduled to work past midnight and then be given another day off later. When you work, but then can't enter those hours into MedHub, it is a problem. Please contact the HOA immediately if this has happened to you. Vacation days are precious and you shouldn't have those taken from you.
This issue was resolved last year, through the grievance process, and if it is happening again, we need to know about it so we can address the issue and make you whole.
Please the the following FAQ for additional information:
House Officer Schedules
What the Collective Bargaining Agreement has to say about your schedule.
You must receive your detailed schedule 30 days in advance. Many of you receive your block/rotation schedule 6 months or even a year in advance. However, you must receive your detailed schedule 30 days in advance. Your detailed schedule should include specific days on and off; you should also know your expected start-time and location.
- A detailed schedule should be posted 30 days in advance.
- Once posted, work schedules shall not be arbitrarily changed.
- Changes to posted schedules may be necessary due to unforeseen circumstances.
- Programs will attempt to minimize such changes
The only exception is for the July schedule for incoming house officers.
Vacation Adjacent Schedules
A vacation day is a full calendar day; starting at midnight (12:00 AM) and running entirely through the last minute of the day (11:59 PM). You may not be assigned an overnight shift or call that extends past midnight and into your scheduled vacation day.
Holiday Blocks are not vacation and are not protected by the contract. Thus, the rules about overnight shifts extending into your time off do not apply.
Educational and clinical work hours must be limited to 80 hours per week over a 4-week average.
Residents must receive 1 day off in 7 averaged over a 4 week period. The day off must be a full calendar day free from all responsibilities. The intent is that no house officer would work more than 2 weeks without a day off. Vacation days do NOT count as release time.
What Counts Toward Work Hours?
- Clinical and educational activities related to the residency/fellowship program
- Inpatient Care
- Outpatient Care
- Administrative duties relative to patient care
- The provision for transfer of patient care
- Time spent in-house during call
- Time spent on-site when taking at-home call
- Scheduled activities such as conferences
- Clinical work done from home, such as charting in the EMR and patient-related phone calls
What does not count?
- Reading, study, or preparation time spent away from the work site
- At-home call (except active patient care such as charting and phone calls or time spent on-site)
Official Contract Language
¶63 - With respect to House Officer work schedules and release time, the Employer is responsible for remaining in substantial compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements.
¶64 - Clinical and educational work hours are defined as all clinical and educational activities related to the residency/fellowship program; i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities such as conferences. Clinical work done from home, such as charting in the EMR and patient-related phone calls must count towards the clinical and educational work hour limit. Clinical and education work hours do not include reading, study, or preparation time spent away from the duty site. At-home call, defined as call taken from outside the House Officer's assigned site, is not included in the clinical and educational work hour calculations except for time spent in active patient care responsibilities. Time spent on the hospital premises after arriving from "at home call" are also included in the clinical and educational hour calculations.
¶65 - Clinical and educational work hours must be limited to eighty (80) hours per week, averaged over a four (4)-week period, inclusive of all in-house call activities and designated off-premises activities. Residents must be provided with one (1) day in seven (7) free from all educational and clinical responsibilities, averaged over a four (4)-week period, inclusive of call. For purposes of this Article, one "day" or "release time" is defined as one (1) continuous twenty-four (24)-hour period, free from all clinical, educational, and administrative duties. Although the one (1) day free in seven (7) is averaged over a four-week period, the normal expectation and intent is that a House Officer would not work more than two (2)-weeks without a day off.
¶66 - It is a responsibility of the House Officer to accurately report clinical and educational work hours to their Program Director by logging them in MedHub within the specified time frame and reporting any frequent or unusual violations directly to the Program Director. The Program Director, representing the Employer, is responsible for monitoring clinical and educational work hours for compliance with the above standard. In the event that a House Officer does not obtain release time in accordance with the standards set forth in paragraph 65, an alternative day off will be scheduled within the four (4)-week period. If alternative day(s) off cannot be scheduled then the House Officer will receive additional compensation equivalent to 1/365th of their annual base salary, for each day of release time that is not provided. Also, the Employer must immediately discontinue any work schedule practices that are not in compliance with these standards.
¶67 - If a House Officer's schedule is inconsistent with the above, the House Officer or the House Officers Association may request the work schedule to be reviewed by the Program Director. If work schedule concerns are not resolved to the satisfaction of the House Officer, the House Officer or the House Officers Association may appeal any work schedule concerns to the Graduate Medical Education Committee, or their designee. In such a situation, the decision of the Graduate Medical Education Committee will be final. It is further agreed that there shall be no retaliation, in any form, towards any House Officer as result of requesting review of their work schedule.
¶68 - It is further understood that days off taken as vacation days will not be counted as release time as defined in paragraph 65. For example, if a Resident works the first two (2) weeks in a month, and takes the latter two (2) weeks as vacation, the resident shall still be entitled to two release days for the first two (2) weeks in that month.
¶69 - If, during the term of this collective bargaining agreement, there is a change in the clinical and educational work hour standards specified by ACGME requirements, then those regulatory standards will take precedence over this language, and the parties will abide by any new standards promulgated by the ACGME. However, in no case will clinical and educational work hours exceed the limits set forth in paragraph 65. Prior to implementation of any change of practice due to a change in ACGME standards, the Employer and the House Officers Association will meet to review the revised standards, and discuss implementation plans.
¶70 - The Employer recognizes that advance notice of work schedules is an important factor in a House Officer's ability to manage their professional and personal responsibilities. Effective November 1, 2020, Programs shall post House Officer rotation call/work schedules a minimum of fifteen (15) calendar days prior to the start of the rotation/block. Effective July 1, 2021, Programs shall post House Officer rotation call/work schedules a minimum of thirty (30) calendar days prior the start of the rotation/block. Once posted, work schedules shall not be arbitrarily changed. It is understood, however, that changes to posted schedules may be necessary due to unforeseen circumstances. Operational and patient care needs may require adjustments or additions to posted rotation call/work schedules from time to time, either prior to or during the rotation/block. Programs will attempt to minimize such changes. The Program Director retains sole final discretion to set and revise schedules, and to resolve scheduling disputes. Notwithstanding the foregoing, the Employer is not required to post rotation call/work schedules for the month of July in advance for incoming House Officers.
¶71 - House Officers are responsible for meeting any program timelines or requirements related to schedule requests. If the House Officer does not submit their requests by the specified deadline, they forgo the opportunity to have such requests accommodated for the applicable rotation/block.
¶72 - House Officers returning to work from a leave of absence (LOA) shall communicate with their Program Director or the Program Director's designee at least two (2) weeks prior to their expected return-to-work date to confirm the date and discuss any matters related to the House Officer's anticipated work schedule upon their return.